Do I need to come to therapy every week?

‘Do I need to go to therapy every week?’ is one of the questions clients ask me the most often, particularly when we first meet to discuss the possibility of working together.

And it’s a great question: there’s no denying that therapy is a significant investment of your time, money, and emotional effort. Understandably, you would want to know if this investment is worth it, and the cognitive, rational, budget-conscious part of us always wants to gain some certainty and a sense of how long the process of therapy will take before we start to feel better. It is in our nature to want to know how something will go, and what the outcomes will be, before we allow ourselves to engage in any process.

My answer, as with so many aspects of counselling and psychotherapy, is ‘It depends’.

Annoying as this might be, and vague as it might sound, there are reasons behind why it may or may not be appropriate to come to weekly sessions. It can depend on the stage of the therapy, the nature or complexity of the issues you are looking to work on, your previous level of experience with and feelings about coming to therapy, the phase and strength of our therapeutic relationship, and practical issues such as your schedule and budget.

1. Weekly sessions can build a stronger foundation at the start of therapy

In general, I tell clients that, yes, particularly in the beginning phase of therapy, weekly sessions can be really beneficial in getting the ball rolling, establishing the therapeutic relationship, and building momentum as we get to know each other and get into the work. As the therapeutic relationship has been shown to be one of the most important factors in successful counselling, it’s well worth investing the time and frequency at this early stage.

In my clinical experience, I have noticed that those clients who attend weekly appointments for the first 4 to 8 sessions tend to make more progress more swiftly than those who attend every other week. That’s not to say that fortnightly doesn’t work: it just might take longer to see the same results. It’s similar to endurance sport and resistance training (which I often find have similarities to therapy and mental health). If you were to work out or run once a week or once a fortnight, you would still be becoming fitter: you would just likely see more progress sooner weekly than you would if you trained fortnightly.

2. Deeper issues can be better ‘held’ through weekly sessions

Similar to the point above, if a client is coming to therapy to work on or unpack emotional content that they have been carrying around for a long time, this can be better ‘held’ or contained within weekly sessions. Part of counselling involves providing a safe container for the difficult and painful feelings and experiences that we can come up against in life. The consistency of frequent, weekly sessions can make a real difference for a client in feeling secure, safe, and familiar with the process of therapy. This can be particularly suitable for work including trauma, depression, bereavement or loss, or burnout or emotional overwhelm, or if the client has experienced a lot of unpredictability or chaos in their lives and relationships.

Fortnightly sessions might be more suitable when the work includes long term personal development, managing ongoing life events, or a continued source of self-care and self-improvement.

3. Weekly sessions can help to focus and become familiar with how therapy works

If you’ve not had therapy before, I would typically suggest that you start with weekly sessions, to help you become familiar with how therapy feels and how the process works. Therapy offers the opportunity to experience ‘safe uncertainty’, in that we don’t work to a script, schedule, or set of instructions. As therapist and client learn what it means to be you, we both enter into the unknown together; which can provoke a lot of anxiety and requires a level of trust. Both of which can be aided by attending weekly sessions.

It’s also surprising how much can happen in our lives over a two week period. While fortnightly sessions can still be incredibly valuable, it can often be the case that we spend the first half of the session ‘catching up’ on the client’s life over the past two weeks as we find the thread from the previous session. In the early stages of therapy, when we are working through a lot of material, weekly sessions can offer a more focused approach than fortnightly.

4. As the therapeutic relationship strengthens, you may not need to attend as frequently

Once the foundations of the therapeutic relationship have been established, and we have worked through some key issues or completed a piece of work, the option to attend less frequently might be appropriate. For example, I offer fortnightly and extended monthly sessions to clients once we have worked together for a while, and when they feel that they want to continue working together longer-term. This can offer a more sustainable way of continuing to engage in self-care while allowing space for the client to reflect on and implement what they have learned between sessions.

5. Fortnightly sessions can help spread the cost and align with your schedule

Realistically, therapy is a pretty significant financial investment, in addition to being a potentially life-long investment in your mental health and well being. Many clients find that coming fortnightly allows them to find a happy medium when budgeting for self-care. Equally, many clients work a shift pattern or rota and find that fortnightly sessions simply work better with their work schedule, or other commitments such as childcare and studies.

As always, I would encourage you to reflect on any other reasons that you might be hesitant to attend weekly. What feelings come up for you? Do you feel that you need to ‘know’ how it will turn out before taking the leap of faith into the unknown? Have you had painful past experiences of trusting, only to be let down?

Maybe, maybe not.

There’s nothing wrong with any of those feelings; in fact, there’s everything right in bringing them to therapy, and just noticing them. After all, that’s why we’re here.

What it comes down to is what suits you as an individual. As I’ve said before, therapy is not a one-size-fits-all treatment: it’s an organic process that’s as unique and nuanced as you, the client, are. While there are benefits to weekly sessions at the start of therapy in particular, you are the expert in yourself and you hold decision-making power in the therapeutic process.